How to Save on Prescription Drug Costs

The following is a guest post from Health Harbor.

It is no secret that for decades, personal healthcare expenditures have increased at a rate greater than inflation.  This had led us to a breaking point today, resulting in the calls for health care reform.  Within the increase, however, are some interesting sub-trends.  We spend fewer days in the hospital.  We spend more on outpatient services.  And as a society, we spend way more on prescription drugs than we ever have before.

Some would see the increase in prescription drug spending as a good thing.  There is no doubt that drug therapy can often be the most cost-effective way of treating a condition and it should often be encouraged.  Treating high blood pressure with drugs, for example, has a lower price tag and will likely produce a higher quality of life than suffering its effects of a stroke or heart attack.  Faithfully following a prescription drug regimen can defer or eliminate the need for surgery or other invasive treatments.

What, then, do you need to know about prescription drug purchases, and how do you make sure those costs fit within your personal budget?  Here are a few relatively recent trends in the prescription drug world that can help you make your healthcare dollar go farther.

• $4 Generic Drug Trend.  Most savvy readers know that large retailers such as Walmart, Target, and Costco each unveiled a list of $4 prescriptions back in 2006, enabling consumers to get common generic drugs at deep discounts (some state regulations prohibit it, but most allow it).  What people may not know is that the trend has continued to expand, both in terms of the number of drugs offered on stores’ lists, as well as the number of chains participating.  Kroger, Safeway, Walgreen’s, Ralph’s, Food4Less, Food Lion, and others have joined the fray, making $4 prescriptions available in all but the most remote of rural areas.  While there is something to be said for the continuity of a one-pharmacy relationship, shopping around for discounted generics can save you money.

• Insurance Drug Tiering Trend.  For about a decade, insurances have increasingly “tiered” drugs into three or four tiers, beginning with generics, working up to preferred non-generics, non-preferred, and often a 4th tier.  The patient’s copay goes up exponentially with each tier, from an average of an $11 copay for a generic to $71 for a 4th-tier drug.  Since it is now more complicated than simply asking “generic or brand name”, it is up to the patient to understand how an insurance’s tiering works, and to have the discussion about drug tiers with one’s doctor.  He or she may have access to the insurance’s formulary and can help guide the prescription to a lower-cost alternative.

• Brand-Name Drug Patent Expirations.  Several costly, brand-name drug patients have expired in the past two years, creating a flood of new generics that didn’t exist before.  Popular drugs such as Fosamax, Advair, Topamax and others that accounted for more than $20 billion of consumer spending are now generics, part of a huge wave of patent expirations in 2008 and 2009.  If you were taking a brand-name drug before, check with your physician or pharmacist to see if there is a good generic alternative on the market.

With a little diligence and consumer research, you may be able to shave a few dollars off your prescription drug bill.

Comments

[Mrs D2S]

Not all $4 lists are identical, but most large chains will price-match. Just ask.

When your physician writes a prescription for you, ask them if it's available in generic. If you have an iPhone you can download a program called Epocrates which should let you determine that yourself, and give a rough retail value. In the past week, I've seen prenatals that run $50 a month on insurance, when a generic for $4 could be paired with a couple over-the-counter items (stool softener and DHA), and a young girl get prescribed Yaz that also was $50 on insurance. Why not have her try a $9 option first?

And just an aside, Advair does not have a commercially available generic yet.

[Juan Batista]

Nicely done

[Kasey]

For those with a low income, most drug companies have a "Patient Assistance Program" with free meds for those who qualify. If interested, information can be found any of the following sites: rxhope.com, pparx.org, or (my favorite)needymeds.org

Qualifications for these programs differ by company, the forms are often onerous, and your doctor's involvement is require (usually just a signature, but sometimes receiving and dispensing). So, if generics are available at $4, the generic is often the easiest choice.

[Drum69]

fingertipformulary.com is also a great source for finding out if your meds are covered by your insurance, and what tier it's on.

FYI, for every health care dollar spent today, only TEN CENTS goes toward prescription medications. Interestingly, that has changed little since 1965. 30 cents of every health care dollar is spent on hospital/ER visits. 20 cents of every health care dollar is spent on doctor visits.

Health Harbor makes a great point about prescription meds: "Some would see the increase in prescription drug spending as a good thing. There is no doubt that drug therapy can often be the most cost-effective way of treating a condition and it should often be encouraged..."

Not to mention limiting or preventing hospital or ER visits, which is where most of our healthcare dollars are spent. And if the patient isn't paying for these visits, we are, either via increased insurance premiums or with our tax dollars (Medicare & Medicaid).

Kasey was good to point out the patient assistance programs that are available. Another good one is TogetherRx.com. If patients want to save money on their medications, they need to be more proactive to find out about these programs by asking their doctors and pharmacists about them. And the doctors and pharmacists need to be up to speed on these as well.

[CJ]

You fail to mention the cheapest way to save on prescription medications - change your lifestyle.

"Treating high blood pressure with drugs, for example, has a lower price tag and will likely produce a higher quality of life than suffering its effects of a stroke or heart attack."

-It's even cheaper to treat it with diet and exercise, not to mention that diet and exercise will do far more for quality of life than any drugs could ever do.

It's always amazing to me that there's a strong correlation between poverty and obesity. Obesity used to be a problem of the royalty, who had extra $$ to blow on fine foods, etc. One would think that people would eat less if they had less income, but it appears that those with less income simply make poorer choices with their nutrition, e.g. eating 'cheap' fast food that is ridiculously high in calories.

[brooklyn money]

I take an expensive pill. It costs $59 a month with insurance, however if i used a generic or another brand I could easily pay A LOT less -- like $5.00. However I want this pill because it works with my body while the others don't. I did some research and found out the drug company has a discount program whereby patients never have to pay more than $24 for their prescription. I'm so excited to start using this! So do some research and see if the drug company that makes the pills you take has a discount or subsidy program.